Hepatitis B is an inflammation of the liver that can be caused by viruses. The presentation discusses hepatitis B, which is one of the most common types. It can cause both acute, short-term infections as well as chronic, long-lasting infections. The virus is transmitted through bodily fluids and from mother to child. While most acute cases resolve, chronic cases can potentially lead to serious liver problems like cirrhosis or cancer if left untreated. Vaccination, proper hygiene, and medical treatment can help prevent and manage hepatitis B infections.

1. Hepatitis B Presentation.
By
ANUGOM A. Emeka

2.  Overview of Hepatitis and Hepatitis B
 Functions of The Liver
 Transmission of Hepatitis B
 Symptoms of Hepatitis B
 Diagnosis of Hepatitis B
 Prevention of Hepatitis B
 Treatment of Hepatitis B
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Agenda

3.  HEPATITIS is inflammation of the
liver. It may be caused by
1.) Excessive Alcohol intake
2.) Various drugs and chemicals,
3.) Certain Medical conditions
and
4.) MOST commonly by various
viruses that infect the liver, leading
to Viral hepatitis.
 The most common forms of viral
hepatitis are Hepatitis A, B and C.
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What is Hepatitis B?

4.  Hepatitis B can cause short-
term(ACUTE) infection that
may/may not cause any symptoms
and the person gets better on his
own in most people. However a few
progress to persistent (CHRONIC)
infection and may remain well but
pass the infection to others.
 Some people develop serious liver
problems.
 The virus is mainly transmitted by
sexual contact, Needle sharing to
inject drugs and from mother to
baby.
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What is Hepatitis B?

5.  Hepatitis B infection is a global
health problem, with estimated
two(2) billion people infected with
the virus.
 More than 350 million have chronic
(long-lasting) liver infections.
 Over 600,000 people die each year
from liver cirrhosis/cancer).
 Hepatitis B virus induced liver
cancer is the third commonest
cause of death in men and also
common in women.
 Its mode of transmission though
similar to HIV, is 50 to 100 times
more infectious than HIV. 5
Prevalence of Hepatitis B

6. It is located in the upper right part of the
abdomen and carries out the following
duties:
- Glycogen storage (Body Fuel) derived
from sugars and when required, is broken
down to glucose and released into
bloodstream.
- Helps process fats and proteins from
digested food.
- Makes proteins essential for blood clot
(clotting factors)
- Process medicines that people ingest
- Help remove or process alcohol, poisons
and toxins from the body.
- Produces bile that breaks down fats in
food so that they can be absorbed from
the intestine.
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Functions of the Liver

7.  Vertical Transmission (From Mother
to child) this is very common in
endemic areas, during child birth.
Women are now being tested for
hepatitis B when they are pregnant.
 Horizontal Transmission (Person to
Person) via contact with blood and
body fluids like semen, vaginal
secretions and saliva) of an infected
person. These are common means of
transmission in the UK and US
through:
- Having unprotected sex with an
infected person who is usually
unaware that he is infected.(even
oral sex can transmit hepatitis B)7
Transmission of Hepatitis B

8. - From infected blood. only a tiny
amount in contact with a cut or
wound on your body permits the
virus entry into the bloodstream. For
example:
1. Needle sharing and/or any injecting
equipment to inject drugs.
2. Blood transfusion (especially in the
past, now most blood is screened
for hepatitis B before transfusion)
3. Needle stick accidents after using
on an infected person.
4. Sharing toothbrushes, razors and
other items contaminated with
blood. (the virus can live outside
the body for more than a week)8
Transmission of Hepatitis B

9. 5. From using non-sterile
equipment for dental work,
medical procedures, tattooing,
body piercing, etc.
6. A bite from an infected person,
or their blood spills on a wound
on your skin or on your eyes or
into your mouth.
NOTE: The virus is not passed on
during normal social contact
such as holding hands, hugging
or sharing cups or crockery.9
Transmission of Hepatitis B

10.  It has two phases:
 Acute Phase (When one is first infected)
 Chronic(Persistent) Phase (When the virus
stays for the long term).
 ACUTE INFECTION:
This is within 1-6 months incubation period,
when the person first gets infected. It
usually resolves after a few weeks
courtesy of the immune system and is
rarely life-threatening (Fulminant
Hepatitis).
In Half of the cases there are NO symptoms,
or mild flu-like symptoms, so one is usually
unaware of the infection, including
newborn infected at birth.
10
Symptoms of Hepatitis B

11.  The symptoms for acute infection include:
 Feeling Sick (Malaise)
 Vomiting
 Abdominal pains
 Fever
 Jaundiced (Yellow discoloration of
eyes/skin), this may lead to dark urine and
pale faeces.
 In over 9 out of 10 cases in Adults, virus is
cleared from the body by the immune
system within 3-6 months, and individual
becomes non-infectious and immune to
further infection.
 However in over 9 out of 10 Newborn
babies infected from their mothers, virus
remains long-term.
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Symptoms of Hepatitis B

12.  CHRONIC INFECTION:
This is when it lasts longer than 6 months.
 2 out of 3 remain well with no liver damage,
but become carriers, transmitting the
infection to others.
 1 in 5 carriers eventually clears the virus
from their body naturally after several
years.
 Some develop persistent liver
inflammation and the symptoms include:
 Muscular aches
 Tiredness and feeling unwell (Malaise)
 Alcohol Intolerance
 Poor Appetite
 Pain over liver (Right upper quadrant)
 Jaundice
 Depression
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Symptoms of Hepatitis B

13.  The symptoms vary with severity, as
some may have no symptoms at all.
 Some develop liver Cirrhosis (Scarring
of the liver and can progress to liver
failure after several years.
 Some patients with cirrhosis can
progress to Liver Cancer, after a
period of time.
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Symptoms of Hepatitis B

14.  Several Blood Tests are done:
 HbsAg (Hepatitis B Surface Antigen): If it
is positive, other tests are done to check
the severity of infection, Liver
inflammation and liver damage.
 Tests to detect other parts of virus to
ascertain how active it is (e.g Hbc-IgM)
etc. (to determine liver damage
likelihood)
 Liver function tests (To measure the liver
enzymes)
 Liver Ultrasound Scan
 Liver Biopsy (To show extent of
inflammation and cirrhosis)
 Other tests are based on specialized and
based on severity of condition and
ascertaining immunity for the disease as
well.
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Diagnosis of Hepatitis B

15.  Immunization:
Three doses are required for full protection,
with the 2nd dose 1month after the 1st dose
and the 3rd dose 5months after the 2nd
dose. A test maybe required after the last
dose to ascertain immunity is attained,
because in 1 out of 10 cases, a booster dose
maybe required in 5years.
If you are travelling to a high risk region an
accelerated schedule can be utilized,
though it may not be as effective as the
above and thus a fourth dose is given after
12months. They comprise the following:
- Taking the 3 doses 1 month apart or
- Taking 2nd dose 7days after the 1st dose and
the 3rd dose 21days after the 2nd dose
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Prevention of Hepatitis B

16.  Those to consider Immunization:
1. Workers likely to come in contact
with blood products/increased risk
of needle stick injuries, assault etc.
2. People injecting street drugs, their
partners and children
3. People who change sexual partners
frequently ( especially homosexuals
and sex workers)
4. People who live in close contact with
someone infected with hepatitis B
5. People who regularly receive blood
transfusions
6. People with certain Kidney or Liver
Diseases. 16
Prevention of Hepatitis B

17. 7. People who live or work with people
with learning difficulties.
8. Families adopting children from
countries with high/intermediate
prevalence of hepatitis B, when the
child’s status is unknown.
9. Foster carers
10. Prison inmates
11. Travelers to countries where hepatitis B
is common. And place themselves at
risk like: sexual activity, injecting drugs,
undertaking relief work and/or
participating in contact sports or
requiring dental procedures in these
countries or procedures that may not
be done with sterile equipment.
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Prevention of Hepatitis B

18. Those Ineligible for the Vaccine:
1. Those with any illness causing a high
temperature.
2. People with severe reaction to the vaccine in
the past should avoid booster doses.
NOTE: It maybe given in pregnant and breast
feeding mothers if necessary.
Post-exposure Prevention:
Injection of antibodies (Immunoglobulin) and
starting course of immunization.
Prevention in New-born babies:
- Screening for pregnant women, if positive, her
baby is given antibodies injection and
immunization started after birth (Transmission
is mainly at childbirth and not during
pregnancy) 18
Prevention of Hepatitis B

19. Prevention of Transmission To Others:
- Avoid sex with anyone (Especially without
condoms) until they are fully immunized
and checked to confirm it has worked.
- Don’t share any Injecting equipment
- Don’t donate blood or semen or carry a
donor card
- Don’t share razors, toothbrushes etc, that
maybe contaminated with blood.
- Cover any cuts or wounds with a dressing
- If any blood spills on the floor accidentally,
clean with bleach.
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Prevention of Hepatitis B

20. TREATMENT FOR ACUTE
INFECTION:
 No treatment can clear the virus
from body, rather treatment is
aimed at easing symptoms like:
Drink Plenty water to avoid
dehydration.
 No treatment can prevent acute
hepatitis from becoming chronic.
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Treatment of Hepatitis B

21. TREATMENT FOR CHRONIC INFECTION:
 No curative treatment , but tries to delay
or prevent development of complications
like liver damage and cirrhosis. There two
types of treatment currently given:
 INTERFERON: Similar to interferon
produced in the body. It boosts immune
system to fight infection and is given
weekly.
 ANTIVIRAL DRUGS: e.g Lamivudine,
tenofovir etc, they try to stop the virus
multiplication in the body. Drug
combinations maybe taken.
 Treatment is usually continued for years
and patient regularly monitored.
 NOTE: Resistance to drugs may also
develop.
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Treatment of Hepatitis B

22. LIVER TRANSPLANT:
 Considered in advanced Cirrhosis.
Outcome is good, but the new
liver may eventually get damaged
by persisting hepatitis B infection.
DIET AND ALCOHOL:
 Advised to eat normal healthy
balanced diet
 Avoid Alcohol especially in those
with liver inflammation, as this
increases the risk and speed of
developing cirrhosis.
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Treatment of Hepatitis B

23.  http://www.patient.co.uk/health/Hepatitis-B-Immunisation.htm
∗ http://www.patient.co.uk/health/Hepatitis-B.htm
 http://www.who.int/immunization/hepb_position_paper_key_refs_s
ummaries.pdf
∗ http://www.emedicinehealth.com/slideshow_hepatitis_pictures/artic
le_em.htm
 http://www.slideworld.org/slidestag.aspx/hepatitis-b
∗ http://www.who.int/csr/disease/hepatitis/HepatitisB_whocdscsrlyo2
002_2.pdf
∗ http://www.tiszaivandor.com/wp-content/uploads/2011/07/hepatitis-
b.jpg
∗ http://reference.medscape.com/features/slideshow/hepatitis
∗ http://www.immunize.org/photos/hepatitis-b-photos.asp
∗ http://www.medicinenet.com/hepatitis_b/article.htm23
Credits

24. Questions
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